Rapid course of CNV and response to treatment in a case of PIC
Purpose
To report the rapid course of choroidal neovascularization(CNV) and its response to intravitreal injection(IVI) of aflibercept in a case of punctate inner choroidopathy(PIC).
Methods
Case report
Results
A 22-year-old woman presented with blurred vision and central scotoma in the right eye(RE) for 1 year and left eye(LE) in recent 2 weeks. Best corrected visual acuity was 0.3(RE, -6.25 -1.00 X 170) and 0.5(LE, -6.25 -1.50 X 180). Ocular examination showed bilateral yellowish white chorioretinal lesions at posterior pole without ocular inflammation. There was more pigmentation in RE than LE. SD-OCT showed retinal pigment epithelium(RPE) disruption and hyperreflective material in both eyes as well as RPE detachment in RE. OCT angiography(OCTA) detected a large CNV at right macula, while a suspicious tiny one at left macula. Fundus fluorescein angiography(FAG) showed staining of the above lesions and leaking CNV at late phase RE>LE. 1 week after FAG, her vision dropped with obvious CNV in LE. IVI aflibercept(2mg/0.05 ml) of LE combining oral steroid was given. 3 days later, the CNV size decreased a lot on OCTA with vision improved to 0.8. IVI aflibercept of RE was given with slow tapering of oral steroid and she kept follow-up by slit lamp exam and OCTA in our clinic.
Conclusion
Like other uveitis related CNV, the CNV in PIC is sometimes difficult to be detected and measured in FAG. OCTA has advantages of three-dimensional view of retinal and choroidal vessels without interference by dye leakage or staining in FAG. We reported a case of PIC, which had distinct features of CNV progression and response to treatment demonstrated by OCTA.
Conflict of interest
No
Author 1
Last name
WANG
Initials of first name(s)
TW
Department
Department of Ophthalmology, KSVGH
City
Kaohsiung
Country
Taiwan
Author 2
Last name
Sheu
Initials of first name(s)
SJ
Department
Department of Ophthalmology, KSVGH
City
Kaohsiung
Country
Taiwan
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